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                 Topic: 
The Impact of Data Integrity and Security on Patient Care

Suppose you have developed an online survey to measure the impact of a new medication on senior citizens, by state of residence. Respondents must record their state of residence. As surveys are returned, you observe that for any given state, multiple variations of the same state name are recorded. For example, Californians return surveys with their state of residence recorded as “California,” “CA,” or “Calif.” 

While this may at first appear to be a minor nuisance, it is in fact a significant data integrity issue resulting from a design flaw. 

Enabling data entry variations in certain data fields (such as “State of Residence”) can result in queries that underestimate the number of respondents or omit complete records from queries.

In this Assignment, you consider the impact of data security and integrity in healthcare database design. You also recommend design strategies that can mitigate data integrity and security risks.

Review this scenario:

The hospital administration is concerned about reports of adverse reactions from a medication given as a part of a new chemotherapy protocol. You are asked to run a report that includes the patients who had anaphylaxis after receiving the medication to span over the past 6 months.
You run the report and find only two cases out of the 100 patients who received the medication. No changes are made to the protocol. The following week, two patients die after receiving the medication.
You are asked to take a closer look at the data. You find that many of the nurses used free text to enter the information about reactions instead of using the checkboxes provided. 

Furthermore, the hospital administration learns about the deaths through posts on social media. The names and causes of death are among the information publicly posted. It is discovered that the posts were submitted by an employee who was terminated several months ago.

To prepare:
Review the scenario.
Review the Learning Resources.
Consider methods used during the database design to prevent duplicate records.
Consider methods used during database design to prevent unauthorized access to healthcare data.
Consider how these aspects of design affect the way that a database is used and how that use ultimately affects patient care.

Write an explanation of how the database design and end-user application affected the patient outcomes in the scenario. Also describe possible causes of the security breach that would have allowed for unauthorized access to this information. Then recommend strategies on how the circumstances in the scenario could be prevented in the future. Be specific and provide examples.

The Impact of Data Integrity and Security on Patient Care

In the scenario, nurses did not adhere to information technology protocols and decided to use free texts to report data instead of the checkboxes provided. This situation led to missing information and negative patient outcomes. There could be possible problems related to the database design that led to a lack of compliance by the nurses. Unfriendly and hard-to-use databases can be problematic (Segun, 2019). Databases should use terms that are easily interpreted or understood by the users. Nurses might have had a difficult time understanding the requirements of the checkboxes, making them prefer free texts.

The scenario also presented security breaches that led to particular information being posted on social media. This problem is related to login and authentication issues. There should be a formal security verification process to prevent unauthorized logins (Hathaliya et al., 2019). The lack of this feature could have led to the former employee gaining access to the system and retrieving important information. There should be regular security updates to ensure those who are no longer eligible to access the system are blocked (Alotaibi & Federico, 2017). This could have helped the situation.

According to Kim et al. (2017), a lack of familiarity with the system is essential. The issues in the scenario can be prevented by training nurses properly to ensure they are familiar with the system, understands it, and can use it easily. In addition, effective security features and updates are needed to prevent security breaches (Ehrenstein et al., 2019). Authorized users should be provided with unique identifiers, which are disabled once an individual is no longer authorized.

References

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173. https://doi.org/10.15537/smj.2017.12.20631

Ehrenstein V, Kharrazi H, Lehmann H, & Taylor, T. (2019). Obtaining data from electronic health records: In tools and technologies for registry interoperability, registries for evaluating patient outcomes: A user’s guide, 3rd Edition, Addendum 2 [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK551878/

Hathaliya, J. J., Tanwar, S., Tyagi, S., & Kumar, N. (2019). Securing electronics healthcare records in healthcare 4.0: A biometric-based approach. Computers & Electrical Engineering, 76, 398-410. . https://doi.org/10.1016/j.compeleceng.2019.04.017

Kim, M. O., Coiera, E., & Magrabi, F. (2017). Problems with health information technology and their effects on care delivery and patient outcomes: a systematic review. Journal of the American Medical Informatics Association, 24(2), 246-250.  https://doi.org/10.1093/jamia/ocw154

Segun, A. (2019). Design and Implementation of Database for Healthcare Information System. (A project work for Master of Science degree in Information Technology Southern New Hampshire University). https://www.researchgate.net/publication/334491760_Design_and_Implementation_of_Database_for_Healthcare_Information_System_A_project_work_for_master_of_science_degree_in_Information_Technology_Southern_New_Hampshire_University